Counting Heartbeats

How often do you get the opportunity to fully absorb an experience with a hospital?
Sure, you go when you’re sick or maybe you accompany someone else, but how closely do you pay attention to the care you are receiving, the instructions you are given and the number of people revolving around you, all focused on whatever it was that brought you through the hospital doors?
I suppose that depends on where you sit at the time. Or in my case, where I was being carried to via gurney.
I had the unique opportunity to take part in a simulated heart attack in a scenario created by the senior management and public relations teams of the Greenville Hospital System. I actually had a choice about the scenario I selected, and I figured that since I had already experienced a relatively drama-free pregnancy and delivery with my own daughter, there was no need to volunteer for the “pregnant mother” scenario.
Aside from my interest in gaining a first-hand understanding of how heart trauma or a myocardial episode is handled, I know that the incidence of heart disease in African American women in the U.S. has reached an alarming rate, and is needlessly snuffing out lives in the Greenville community and many others. I needed to know what I should be doing to protect my own heart from being added to the statistics. I also wanted to learn, if I could, the actual symptoms of a heart attack, so if I ever encountered one — personally or witnessing someone else — I wouldn’t have to guess about what to do. As a devoted fan of NBC’s “ER,” I couldn’t pass up the opportunity to fly through the doors of a real emergency room and be surrounded by people yelling “Stat!” or “BP is 80 over 50” or “Pressure’s dropping! Get Carter or Kovach now!”
Most heart attacks are caused by a clot which blocks one of the coronary arteries, the blood vessels that bring blood and oxygen to the heart muscle. A clot in the coronary artery interrupts the flow of blood and oxygen to the heart muscle, leading to the death of heart cells in that area. According to the National Institutes of Health, it is difficult to estimate exactly how common heart attacks are because as many as 200,000 to 300,000 people in the U.S. die each year before medical help is sought. It is estimated that approximately 1 million patients visit the hospital each year with a heart attack, and I was about to be one of them.
The gurney, accompanied by three EMS technicians, Renee McDonald, R.J. Buchanan and Mike Reese, and Kathy Becker, associate chief nursing officer and interim director of nursing for GHS’ emergency services, my scenario guide, met me in the newsroom, just inside the main doors. In the scenario, I started having chest pains in the midst of my morning coffee and my co-worker called 911. The technicians explained that in an actual myocardial infarction or MI, I would feel lightheaded. Most often, by the time they arrive, the person having the episode is unconscious or close to it. I surmised that we were all going through some unfamiliar territory, as having a heart attack patient be conscious enough to explain how she feels is almost a luxury.
As I was belted on to the gurney, 12 probes were taped all over my upper torso in order to monitor my heart rate and activity with an electrocardiogram. While my “symptoms” and personal statistics (non-smoker, weight, last meal eaten) were being gathered, one of the technicians explained that the emergency room doctor was already aware of my condition and the probes would register my heart activity to him in the emergency room. I was immediately impressed that my experience, though imaginary in this instance, was anticipated, and that was the usual procedure. So much for flying through the doors and catching anybody off-guard.
I was also informed that I would have also received an aspirin to help alleviate my symptoms, and it is generally recommended that people who are prone to heart disease should take aspirin on a regular basis, and those experiencing a real heart attack should take an aspirin as soon as possible. With that, I was connected to intravenous fluids, a oxygen monitor was taped to my left index finger and I was lifted up and adjusted to a 45-degree angle and wheeled onto the elevator. Of course, I asked the technicians what they would have done if I was on a higher floor in a building without elevator access, and they explained that they would have used a different type of gurney and other equipment to get to me. They conceded that their biggest challenges occur when prospective patients have issues with weight, which is also one of the biggest risk factors of heart disease.
Although it wasn’t kept a secret, not all of the employees at The Greenville News realized what was going on, and I wondered what they could have been thinking. I know at least one person had to say, “I know I just saw her walk by here not too long ago.” I admit that I probably offered up a little light-hearted comic relief when I insisted that the EMS techs cover my head in order to save my hairdo from the light drizzle that had begun while we made our way into the ambulance.
My next surprise: the ride to the hospital was smooth as silk. I don’t know why I thought it would be bumpy, but when I see ambulances in passing, moving quickly through the traffic snarls, I imagine that the poor soul inside is being tossed to and fro. That said, this soul is a witness to the contrary. I was asked how I felt, and the EMS techs translated the terminology they were using to discuss my condition with the doctor in the emergency room.
When we arrived in the ER, we were met by Dr. Martin Lutz, director of emergency services. He introduced himself, asked me if I knew where I was and explained that I was having a myocardial infarction or what is commonly known as a heart attack. He showed me a printout of my heart activity and three other nurses, Ronna Richard, Mary Hagood and Judy Young, introduced themselves and began helping the EMS techs to transfer me from the ambulance gurney to an ER bed. My probes were connected to an ER monitor and we could all see my heart activity overhead, and a gown was placed over my clothes. At that point, my personal information would have been typed directly into the Computer On Wheels or COW, and an identification bracelet would have been printed out for me on the spot.
At that point, I was considered stabilized and my next stop was a visit to the Cath, or Cardiac Catheterization lab, to determine the severity of the “blockage” in my artery. I immediately noticed that it was at least 10 degrees colder in there than in the ER.
Ms. Becker explained that the lab has to be kept cold due to the sensitivity of the machinery. I was transferred from the hospital bed to the metal lab table, and my probes were hooked into the lab’s echocardiograph.
The Cath technicians, Beth Cook, Kathy Winslett and Meredith Thackston, explained that at this point in a real MI, they could determine where my blockage was located through a cardiac catheterization. The cardiac cath would determine the likelihood of my having to obtain a stent implantation. A minimally invasive procedure, coronary catheterization involves having a catheter placed through another small tube (called a catheter sheath introducer) and then inserted into your groin or arm. The doctor will then guide the catheter to your heart and then into the opening of your arteries. Once the catheter is positioned, your doctor will take pictures of your heart. If your cardiac catheterization shows that there are one or more blockages in your coronary arteries, your doctor may recommend further treatment, one of which could be a balloon angioplasty.
I was quite relieved to not have to actually undergo the stent procedure; the description of the process was enough for me. I was transferred back to the hospital bed and transported to a recovery room in the Coronary Care Unit, where I was met by Dr. Morris Williams and nurse Karen Balon. He explained the recovery process and what a patient’s next steps are in accordance with lifestyle changes and being attentive to heart health through a prescribed HeartLife regimen at the Life Center. I appreciated his confidential treatment of the whole issue, even if it was a scenario, and every point in the day I felt like I was being treated with respect.
After the consultation with Dr. Williams, the probes were removed and I was assisted out of the hospital gown. Bubber Hutto, one of the red-coated GHS volunteers, assisted me out of the bed and into the wheelchair for the ride outside to the main entryway. Ms. Becker and the some of the other nurses remarked that my recovery abilities were “remarkable.” I felt remarkable, too, and I genuinely learned a lot more than I thought I would about the experience.
The bottom line is that every interaction I had at every stage of the day involved open, direct communication and thorough explanations of every decision and procedure. There were multitudes of people moving around me, but I never felt as if I was being shuffled along some kind of patient conveyor belt. All of the doctors talked to me, instead of talking over my head. Everyone took the time to translate unfamiliar medical terminology and answered my questions. I learned the names of the nurses, technicians and transporters, and they learned mine.
Was it healthcare to a higher standard? My heart can vouch for it.